Provider First Line Business Practice Location Address:
44185 HIGHWAY 52 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENMARE
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58746-8825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-509-5320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2026